基于sMRI的加速神经导航磁刺激治疗广泛性焦虑障碍1例

李瑶, 李益, 娄万芸

Abstract

广泛性焦虑障碍（GAD）是一种常见且易共病的精神障碍，部分患者对药物治疗反应不佳。神经导航经颅磁刺激可借助精准定位提升治疗针对性，加速刺激方案则通过每日多次干预缩短起效时间。本文报告一例54岁男性GAD共病抑郁状态患者，既往经足量足疗程药物治疗效果仍不理想。本次治疗采用基于结构磁共振成像的加速神经导航磁刺激方案，靶向右侧背外侧前额叶，以1 Hz频率、100%静息运动阈值进行刺激，每日3次，每次1200脉冲，连续治疗10天，并联合帕罗西汀与阿普唑仑治疗。结果显示：治疗第5天，广泛性焦虑障碍量表评分自18分降至9分（减分率50.0%），患者健康问卷评分自19分降至9分（减分率52.6%）；治疗第10天，上述评分进一步分别降至3分（减分率83.3%）与7分（减分率63.2%）。随访12周时，两个量表评分均为零分，事件相关电位及近红外脑功能成像提示神经生理指标改善。本案例表明，对于药物治疗效果不佳的GAD患者，基于结构磁共振成像的加速神经导航磁刺激可能是一种安全、快速且有效的辅助治疗选择。

Keywords

广泛性焦虑障碍神经导航经颅磁加速经颅磁个案报告

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